Magdalena Walicka1, Agnieszka Tuszyńska1, Marcin Chlebus2, Yaroslav Sanchak3, Andrzej Śliwczyński4, Melania Brzozowska4, Daniel Rutkowski4, Monika Puzianowska-Kuźnicka5,6, Edward Franek7,8. 1. Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, ul. Woloska 137, 02-507, Warsaw, Poland. 2. Department of Quantitative Finance, Faculty of Economic Sciences, University of Warsaw, ul. Dluga 44/50, 00-241, Warsaw, Poland. 3. Warsaw Medical University, ul. Zwirki i Wigury 61, 02-091, Warsaw, Poland. 4. National Health Fund, ul. Grojecka 186, 02-390, Warsaw, Poland. 5. Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, ul. Pawinskiego 5, 02-106, Warsaw, Poland. 6. Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, Ceglowska 80, 01-809, Warsaw, Poland. 7. Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, ul. Woloska 137, 02-507, Warsaw, Poland. edward.franek@cskmswia.pl. 8. Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, ul. Pawinskiego 5, 02-106, Warsaw, Poland. edward.franek@cskmswia.pl.
Abstract
BACKGROUND: Identifying prognostic factors that are predictive of in-hospital mortality for patients in surgical units may help in identifying high-risk patients and developing an approach to reduce mortality. This study analyzed mortality predictors based on outcomes obtained from a national database of adult patients. MATERIALS AND METHODS: This retrospective study design collected data obtained from the National Health Fund in Poland comprised of 2,800,069 hospitalizations of adult patients in surgical wards during one calendar year. Predictors of mortality which were analyzed included: the patient's gender and age, diagnosis-related group category assigned to the hospitalization, length of the hospitalization, hospital type, admission type, and day of admission. RESULTS: The overall mortality rate was 0.8%, and the highest rate was seen in trauma admissions (24.5%). There was an exponential growth in mortality with respect to the patient's age, and male gender was associated with a higher risk of death. Compared to elective admissions, the mortality was 6.9-fold and 15.69-fold greater for urgent and emergency admissions (p < 0.0001), respectively. Weekend or bank holiday admissions were associated with a higher risk of death than working day admissions. The "weekend" effect appears to begin on Friday. The highest mortality was observed in less than 1 day emergency cases and with a hospital stay longer than 61 days in any type of admission. CONCLUSION: Age, male gender, emergency admission, and admission on the weekend or a bank holiday are factors associated with greater mortality in surgical units.
BACKGROUND: Identifying prognostic factors that are predictive of in-hospital mortality for patients in surgical units may help in identifying high-risk patients and developing an approach to reduce mortality. This study analyzed mortality predictors based on outcomes obtained from a national database of adult patients. MATERIALS AND METHODS: This retrospective study design collected data obtained from the National Health Fund in Poland comprised of 2,800,069 hospitalizations of adult patients in surgical wards during one calendar year. Predictors of mortality which were analyzed included: the patient's gender and age, diagnosis-related group category assigned to the hospitalization, length of the hospitalization, hospital type, admission type, and day of admission. RESULTS: The overall mortality rate was 0.8%, and the highest rate was seen in trauma admissions (24.5%). There was an exponential growth in mortality with respect to the patient's age, and male gender was associated with a higher risk of death. Compared to elective admissions, the mortality was 6.9-fold and 15.69-fold greater for urgent and emergency admissions (p < 0.0001), respectively. Weekend or bank holiday admissions were associated with a higher risk of death than working day admissions. The "weekend" effect appears to begin on Friday. The highest mortality was observed in less than 1 day emergency cases and with a hospital stay longer than 61 days in any type of admission. CONCLUSION:Age, male gender, emergency admission, and admission on the weekend or a bank holiday are factors associated with greater mortality in surgical units.
Authors: Stephanie Russ; Shantanu Rout; Nick Sevdalis; Krishna Moorthy; Ara Darzi; Charles Vincent Journal: Ann Surg Date: 2013-12 Impact factor: 12.969
Authors: C A Polanczyk; E Marcantonio; L Goldman; L E Rohde; J Orav; C M Mangione; T H Lee Journal: Ann Intern Med Date: 2001-04-17 Impact factor: 25.391
Authors: Ndubuisi O C Onyemaechi; Sunday O Popoola; Alexander Schuh; Alex T Iorbo; Itodo C Elachi; Kehinde S Oluwadiya Journal: Indian J Surg Date: 2014-02-27 Impact factor: 0.656